NPI | 1780075424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A174059) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A174059) |
Enumeration Date | 2015-02-17 |
Last Update Date | 2025-07-17 |